Fri Nov 04 2022

68 articles - From Friday Oct 28 2022 to Friday Nov 04 2022

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Guidelines

Guidelines, position statements, white papers, technical reviews, consensus statements, etc…

Clin Kidney J

Adequacy between practice and European guidelines on hyponatremia: a survey among French nephrologists.

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Meta-analysis

meta-analyses and systematic reviews

Nephrol Dial Transplant

A systematic review and meta-analysis of the effect of intravitreal VEGF inhibitors on cardiorenal outcomes.

In trials of intravitreal VEGFi, we did not identify an increased risk of cardiorenal outcomes, though these outcomes were reported in only a minority of cases. There was an increased risk of death in VEGFi-treated participants with diabetic eye disease. Additional scrutiny of post-licensing observational data may improve recognition of safety concerns in VEGFi-treated patients.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Am J Kidney Dis

Light Chain-Only Immunotactoid Glomerulopathy: A Case Report.

We describe a light chain-only variant of ITG. Pathogenesis potentially involves activation of the alternative pathway of complement by a nephrotoxic light chain.

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Clin J Am Soc Nephrol

Climate and the Nephrologist: The Intersection of Climate Change, Kidney Disease, and Clinical Care.

Of note, >90% of dialysis occurs in highly affluent countries, whereas dialysis is much less available in the poorer countries where climate change is having the highest effect on kidney disease. We conclude that not only do nephrologists need to prepare for the rise in climate-associated kidney disease, they must also urgently develop more climate-friendly methods of managing patients with kidney disease.

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Cost-Effectiveness of Dapagliflozin as a Treatment for Chronic Kidney Disease: A Health-Economic Analysis of DAPA-CKD.

In patients meeting the eligibility requirements for the DAPA-CKD trial, dapagliflozin is likely to be a cost-effective treatment within the UK, German, and Spanish health care systems. Clinical trial registry name and registration number Dapagliflozin and Prevention of Adverse Outcomes in CKD (DAPA-CKD), NCT03036150.

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Five-Year Symptom Trajectories in Nondialysis-Dependent CKD Patients.

This study highlights a significant worsening of symptoms in about one third of the participants, whereas the majority reported low symptom severity throughout the study.

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Longitudinal Evaluation of Donor-Derived Cellfree DNA in Pediatric Kidney Transplantation.

In children, donor-derived cfDNA is a valuable, less invasive biomarker for assessment of allograft rejection and injury. Podcast This article contains a podcast at

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Safety and Efficacy of Belimumab in Patients with Lupus Nephritis: Open-Label Extension of BLISS-LN Study.

No new safety signals were identified, and efficacy was generally maintained throughout the open-label phase. Clinical trial registry name and registration number BLISS-LN, NCT01639339.

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Clin Kidney J

Association of secondary prevention medication use after myocardial infarction with mortality in hemodialysis patients.

The use of more evidence-based medications for secondary prevention after MI was associated with a lower risk of all-cause mortality in HD patients.

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Comparison of safety and outcomes related to remdesivir treatment among dialysis patients hospitalized with COVID-19.

Among dialysis patients hospitalized with COVID-19, remdesivir was not associated with higher rates of liver injury or ICU admissions, and demonstrated a trend toward lower 30-day mortality.

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Effect of kidney replacement therapy modality after first kidney graft failure on second kidney transplantation outcomes.

Death-censored second graft survival was similar in al three groups. Our results suggest that after first KT failure, PD is superior to HD in reducing mortality in candidates for a second KT without options for preemptive retransplantation.

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Excessive risk and poor outcome of hospital-acquired peritoneal dialysis-related peritonitis.

PD patients admitted to the hospital had a 4-fold increase in the risk of developing peritonitis. Hospital-acquired peritonitis episodes were more likely culture negative and resistant to antibiotics. They also had a lower primary response rate, a lower complete cure rate and higher mortality than episodes that developed outside the hospital.

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Healthcare resource utilisation and related costs of patients with CKD from the UK: a report from the DISCOVER CKD retrospective cohort.

HCRU and costs associated with CKD impose a substantial burden on the healthcare system, particularly in the more advanced stages of CKD. New interventions that can delay the progression of CKD to kidney failure may not only prolong the patient's life, but would also provide significant resource and cost savings to healthcare providers.

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Increased mortality after kidney transplantation in mildly frail recipients.

Listed kidney transplant candidates frequently show only one PFP frailty criterion. This has an independent impact on patient survival after transplantation.

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Induction immunosuppression and outcome in kidney transplant recipients with early COVID-19 after transplantation.

Older recipients treated with thymoglobulin showed the poorest survival in the Cox regression model adjusted for comorbidities. Thus thymoglobulin should be used with caution in older recipients during the present pandemic era.

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Is there sex disparity in vascular access at dialysis initiation in France? A mediation analysis using data from the Renal Epidemiology and Information Network registry.

Women were associated with a higher risk of starting dialysis through an HD catheter. The effect of sex was mediated by predialysis care, particularly for deprived patients.

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Kidney biopsy in lupus nephritis after achieving clinical renal remission: paving the way for renal outcome assessment.

The median activity index decreased from a baseline value of 6.5 (IQR 2.8-11) to 0 (IQR 0-2) ( = 14 (25%)] according to the treatment. In conclusion, KB2 provides valuable information to guide immunosuppressive maintenance therapy.

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Novel loss-of-function mutations in TNFAIP3 gene in patients with lupus nephritis.

Kidney involvement may be the main feature of the clinical spectrum of HA20, even in adults. Genetic screening should be considered for early-onset LN patients.

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Pseudohypobicarbonatemia in a patient with amyloidosis.

A different enzymatic/photometric assay revealed a normal serum HCO3- level at 21 mmol/L. Additional workup revealed paraproteinemia, which was thought to interfere with the enzymatic process by which his serum HCO3- was measured, resulting in erroneous values.

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Referral rate of chronic kidney disease patients to a nephrologist in the Region of Southern Denmark: results from KidDiCo.

Only a small fraction of CKD patients are followed by a nephrologist. More studies should be performed in order to find out which patients will profit the most from renal referral and how to optimize the collaboration between nephrologists and general practitioners.

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J Am Soc Nephrol

Data-Driven Chronic Allograft Phenotypes: A Novel and Validated Complement for Histologic Assessment of Kidney Transplant Biopsies.

The evaluation of total chronicity provides information on kidney transplant pathology that complements the estimation of disease activity from acute lesion scores. Use of the data-driven algorithm used in this study, called RejectClass, may provide a holistic and quantitative assessment of kidney transplant injury phenotypes and severity.

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Differences in Phosphate and Parathyroid Hormone Concentrations over the Day among Patients on Hemodialysis.

Among patients receiving maintenance hemodialysis, concentrations of PTH and phosphate before a dialysis session vary with the time of day that these values are measured. Consideration of whether these values were obtained at peak or nadir times of the day may be important in treatment decisions.

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Early Effect of the Circular Model of Kidney Allocation in the United States.

Changes in allocation practices (biopsy, machine perfusion, and virtual cross-match) were also evaluated. Results Post-KAS250 saw a two-fold increase in kidneys imported from nonlocal organ procurement organizations (OPO) and a higher proportion of recipients with calculated panel reactive antibody (cPRA) 81%-98% (12% versus 8%; 80% and those with longer dialysis duration, but this was accompanied by an increase in CIT and a suggestion of worsening kidney discards.

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Genomic Disorders in Chronic Kidney Disease Across the Lifespan.

Identification of GDs in these patients can enable a precise genetic diagnosis, inform prognosis, and help stratify risk in clinical studies. GDs could also provide a molecular explanation for nephropathy and comorbidities such as poorer neurocognition for a subset of patients.

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Long Read Sequencing Identifies Novel Pathogenic Intronic Variants in Gitelman Syndrome.

Intronic pathogenic variants explain an important part of the missing heritability in Gitelman syndrome. Long read sequencing should be considered in diagnostic workflows for Gitelman syndrome.

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Nuclear Magnetic Resonance Metabolomic Profiling and Urine Chemistries in Incident Kidney Stone Formers Compared with Controls.

Although NMR-quantified metabolites did not improve discrimination, several urine metabolic profiles were identified that may improve understanding of kidney stone pathogenesis.

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Steroid-Resistant Nephrotic Syndrome-Associated MYO1E Mutations Have Differential Effects on Myosin 1e Localization, Dynamics, and Activity.

Background Myo1e is a nonmuscle motor protein enriched in podocytes. Mutations in variants associated with SRNS.

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Kidney Int

A Phase I/IIa study of autologous tolerogenic dendritic cells immunotherapy in kidney transplant recipients.

Regarding immune monitoring, reduced CD8 T cell activation markers and increased Foxp3 expression were observed in the ATDC group. Thus, our results demonstrate ATDC administration safety in kidney-transplant recipients.

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CD248 induces a maladaptive unfolded protein response in diabetic kidney disease.

While CD248 knockout ameliorated DKD-associated glomerular dysfunction and reverses maladaptive unfolded protein response signaling, concomitant XBP1 deficiency abolished the protective effect in diabetic CD248 knockout mice, supporting a functional interaction of CD248 and XBP1 in vivo. Hence, CD248 is a novel mesangial cell receptor inducing maladaptive UPR signaling in DKD.

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Kidney tubular transcription co-activator, Yes-associated protein 1 (YAP), controls the expression of collecting duct aquaporins and water homeostasis.

These three factors also promoted Aqp4 transcription whereas only GATA2 and GATA3 enhanced Aqp3 transcription. Thus, our results suggest that YAP promotes Aqp2 and Aqp4 transcription, interacts with GATA2, GATA3 and NFATc1 to control Aqp2 expression, while Aqp-2, -3 and -4 exploit overlapping mechanisms for their baseline transcriptional regulation.

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Nephrol Dial Transplant

Extrapolated longer-term effects of the DAPA-CKD trial: a modelling analysis.

Adding dapagliflozin to standard therapeutic management of CKD is expected to have long-term cardiorenal benefit beyond what has been demonstrated in the DAPA-CKD trial, with patients predicted to live longer with fewer complications.

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Glycated albumin to glycated hemoglobin ratio and mortality in diabetic patients on dialysis: a new association.

The GA/A1c ratio was significantly associated with 3-year mortality, especially infectious and cardiovascular mortality, in dialysis patients with diabetes. This ratio may be a promising new clinical indicator of survival in these patients, independent of their current glycemic control and nutritional markers.

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Kidney utilization in the Netherlands - do we optimally use our donor organs?

The classical definition of organ discard underestimates the non-utilization of deceased donor kidneys. Strategies to improve kidney utilization could be a revision of the maximum allowed agonal time in donation after circulatory death, careful consideration in reporting and accepting kidneys from donors with AKI, and a prospectively filled registry of detailed organ discard reasons, including the 'silent' non-utilization before procurement.

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Metabolic acidosis is undertreated and underdiagnosed: a retrospective cohort study.

This analysis of 96 184 patients with laboratory-confirmed MA from 3 independent cohorts of patients with CKD and MA highlights an important diagnosis and treatment gap for this disease-modifying complication.

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Post-transplant diabetes mellitus and renal cell cancer after renal transplantation.

Patients with PTDM must be considered a population at risk for RCC and accordingly, susceptible of active surveillance.

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Social determinants of health and the transition from advanced chronic kidney disease to kidney failure.

Social determinants of health including education, employment, and marital status are associated with suboptimal transitions from CKD to kidney failure.

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Subclinical cognitive impairment in chronic kidney disease is associated with frailty and reduced quality of life.

CI is highly prevalent in non-dialysis CKD-patients. Even mild CI is associated with a decrease in mobility, muscle strength, HRQoL and frailty.

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The influence of repeated flares in response to therapy and prognosis in lupus nephritis.

A progressive number of LN flares is associated with a lower response to therapy and an adverse prognosis for kidney function and patient survival.

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The role of complement in glomerulonephritis - are novel therapies ready for prime time?

In this review, potential benefits and challenges of targeting the complement system in glomerular disease are discussed. We summarise current understanding of the role of complement, and the novel targeted therapies that are being developed for the treatment of glomerular disease.

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Tolvaptan treatment is associated with altered mineral metabolism parameters and increased bone mineral density in ADPKD patients.

Chronic Tolvaptan treatment is associated with increased femoral bone mineral density and significant changes in both mineral metabolism and acid-base parameters in ADPKD patients.

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Towards a better understanding of arterial calcification disease progression in CKD: investigation of early pathological alterations.

Our observations indicate that AMC-related vascular alterations develop early after CKD induction prior to media calcifications being present. Preventive action, related to restoration of NO bioavailability, might combat AMC development.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Clin J Am Soc Nephrol

A Blueprint for Assessing Affordability of SGLT2 Inhibitors in the United States: The Cost-Effectiveness of Dapagliflozin in Three European Countries.

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Can We Turn the Symptom Curve? Symptom Trajectories and Outcomes among Patients with CKD.

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The Role of Anti-B Cell Activating Factor Therapy for Treating Lupus Nephritis.

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Clin Kidney J

Defining diagnostic trajectories in patients with podocytopathies.

We will provide several examples of an integrative view of traditional concepts and new data in patients with suspected podocytopathies, along with a perspective on how a reclassification could help to improve not only diagnostic pathways and therapeutic strategies, but also the management of disease recurrence after kidney transplantation. In the future, the advantages of precision medicine will probably allow diagnostic trajectories to be increasingly focused, maximizing therapeutic results and long-term prognosis.

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Frailty in kidney transplantation: a review on its evaluation, variation and long-term impact.

The criteria currently used to establish the presence and degree of frailty can be rapidly assessed in clinical practice, even in patients with chronic kidney disease (CKD). The main objectives of this work are: (i) to describe the method of evaluation and the impact that frailty has in patients affected by CKD, (ii) to explore how frailty should be studied in the pre-transplant evaluation, (iii) how frailty changes after a transplant and (iv) the impact frailty has over the long term on the survival of renal transplant patients.

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Gain-of-function TLR7 and loss-of-function A20 gene variants identify a novel pathway for Mendelian lupus and lupus nephritis.

Finally, they both may be expressed by kidney cells, potentially contributing to the severity of kidney injury in persons who have already developed autoimmunity. The fact that both genes regulate the same pathway may lead to novel therapeutic approaches targeting the shared molecular pathway.

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Probiotics for kidney disease.

Potential mechanisms of action include modulation of the gut microbiota and increased availability of short-chain fatty acids with anti-inflammatory properties and of nicotinamide. However, the clinical relevance needs validation in large well-designed clinical trials.

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Risk-based versus GFR threshold criteria for nephrology referral in chronic kidney disease.

The shortage in the nephrology workforce has classically led to focused referral on advanced CKD stages preparing for kidney replacement, but the need for hasty referral to a nephrologist because of the urgent requirement for kidney replacement therapy in advanced CKD is still observed and changes are required to move toward reducing the kidney failure burden. The Kidney Failure Risk Equation (KFRE) is a novel tool that can guide wiser nephrology referrals and impact patients.

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Nat Rev Nephrol

Youth-onset type 2 diabetes mellitus: an urgent challenge.

The particularly high risk of the disease in historically disadvantaged populations suggests an important contribution of social and environmental factors, including limited access to high-quality health care, healthy food choices and opportunities for physical activity as well as exposure to stressors including systemic racism and environmental pollutants. Understanding the mechanisms that underlie the development and aggressive clinical course of youth-onset T2DM is key to identifying successful prevention and management strategies.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Clin Kidney J

Qualitative approach to better understand the trajectory of patients with early and moderate stage CKD.

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J Am Soc Nephrol

Centering Anti-Racism and Social Justice in Nephrology Education to Advance Kidney Health Equity.

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The New Kidney-Focused Companies: A Privatized Approach to Value-Based Care and Addressing Social Determinants of Health.

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Kidney Int

On the way to translate GWAS into kidney disease mechanisms.

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Nat Rev Nephrol

AngII autoantibodies after SARS-CoV-2 infection.

Pubmed   Journal   ReadQx   PMC

Derivation of collecting duct organoids.

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Genetics of posterior urethral valves.

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Long COVID: long-term health outcomes and implications for policy and research.

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The pathogenesis of pre-eclampsia in kidney donors.

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Treatment of SLE with anti-CD19 CAR-T cells.

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Nephrol Dial Transplant

Biomarkers of kidney tubule injury and dysfunction and risk of incident hypertension in community-living individuals: results from the multi-ethnic study of atherosclerosis.

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Isolated kidney transplantation under lumasiran therapy in primary hyperoxaluria type 1: a report of 5 cases.

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Letters&Replies

Letters to the editors and authors’ replies

Am J Kidney Dis

Chelation Therapy for Kidney Transplant Recipients With Lead Exposure.

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Estimated Versus Measured Glomerular Filtration Rate in Men at Risk for Mesoamerican Nephropathy.

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In Reply to "Chelation Therapy for Kidney Transplant Recipients With Lead Exposure".

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Pharmacokinetics and Pharmacodynamics of Apixaban in Nephrotic Syndrome: Findings From a Phase 1a Trial.

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J Am Soc Nephrol

Authors' Reply: Most Arginase-1 Positive Cells Are Likely Injured S3 Proximal Tubular Cells Carrying Upregulated Phagocytotic Capacity rather than M2 Macrophages-Too Many To Be True.

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Most Arginase-1 Positive Cells Are Likely Injured S3 Proximal Tubular Cells Carrying Upregulated Phagocytotic Capacity rather than M2 Macrophages-Too Many To Be True.

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